The Congress established Medicare Payment Advisory Commission (MedPAC) as a self-governing agency for advices on Medical reimbursement policy issues. Doing its part, MedPAC sent a report to Congress last...
It has been a year since insurers, Anthem and Aetna, announced their plans to merge with Cigna and Humana, respectively. However, the merger plans are not yet approved by...
Senate Finance Committee Chairman, Orrin Hatch (R-Utah), released a white paper last month, which suggests a few modifications in the federal physician self-referral or Stark law. Titled “Why Stark,...
In latest news, CMS expressed their concern regarding physicians billing Medicare beneficiaries registered with the Qualified Medicare Beneficiary (QMB) program. The QMB initiative is targeted for dual-eligible beneficiaries with...
The US Supreme Court recently issued an undisputed decision on the Universal Health Services v. Escobar case that has great implications for upcoming False Claim Act (FCA) cases. The...
The Department of Justice recently published the results of their largest takedown on Medicare fraud. Almost 301 individuals were arrested in the process and the total frauds accumulated to...
The Office of the Inspector General, HHS recently published a report on off-campus units that were covered under Medicare as provider-based facilities. OIG conducted a study to make sure...
Recently, CMS proposed a few changes to the “…procedures that the Department of Health and Human Services would follow at the Administrative Law Judge level for appeals of payment...
The Medical Trustees recently released their annual report on the Hospital Insurance (HI) trust fund and the Supplementary Medical Insurance (SMI) trust fund. The Medicare program covered around 55.3...
Members of the Healthcare Billing and Management Association (HBMA) recently visited senior CMS staff and chief health policy makers in Congress. The meeting gave HBMA members a chance to...
CMS recently revealed their plans on streamlining EHR reporting requirements for hospitals and eligible professionals. “These changes include a proposal for clinicians, hospitals and critical access hospitals to use...
The increasing concerns over opioid epidemic have forced the US Health and Human Services (HHS) to implement several initiatives to stop the outbreak. Some of the new initiatives include...
The Center for Medicare & Medicaid Services recently proposed a new approach towards Medicare Part B payment, which aims to control how prescription drug cost determines the payment of...
Regional health insurers and many other small co-op plans incurred big charges under the Affordable Care Act’s risk adjustment program. The year 2015 is the second year of risk...
The commenting period set by CMS on the MACRA implementation has ended now. Following that, the American Academy of Family Physicians (AAFP) asked the Centers for Medicare & Medicaid...
The Centers for Medicare & Medicaid Services recently announced that 196 practices would be participating in their proposed Oncology Care Model (OCM). CMS says that OCM is designed to...
CMS invited comments on the proposed Medicare Access and CHIP Reauthorization Act (MACRA) last month, and received hundreds and thousands of remarks on the same. Most noted comment, however,...
The Department of Health & Human Services (HHS) plans to clear all backlogs under their new rules. HHS estimates that the Notice of Proposed Rulemaking (NPRM) on proposed changes...
The immense success of DoD’s “Hack the Pentagon” program has grabbed the attention of Department of Health and Human Services. The recently completed program was able to determine the...
The American Academy of Family Physicians (AAFP) recently joined hands with four other organizations in its attempt to expand the ranks of primary care physicians to where they are...